脊髓拴系综合症(TCS)——23例小儿病例报告

Tethered spinal cord syndrome:A report of 23 children cases

本文报告了经 Amipaque 脊髓造影 CT 检查确诊并行手术治疗的23例 TCS 小儿病例。术后随访1～1.5年总有效率11/23,死亡率1/23。作者认为:凡确诊为 TCS 的患儿均应早期手术解除脊髓拴系;对腰骶部脊髓脊膜或脂肪脊髓脊膜膨出的患儿不能只行肿物切除,而应对脊髓行探查,彻底松解脊髓,以缓解症状减少神经系统病残率。

Twenty-three cases of tethered spinal cordsyndrome(TCS)in children are reported.Therewere 11 males,12 females,the youngest one wasonly two months of age.In these chlidren spina bifida occulta with TCS in 4 cases,myelomeningoceleor lipomyelomeningocele meningocele with TCSin 16 cases and TCS secondary to the operation ofmyelomeningocele in 3 cases.According to Dr.Hoffmen's functional grading scheme for thesechildren both before and after the operationsrevaluated the children's conditions.Follow-upduration was 1 to 1(1/2)years after the operations,the result of surgical therapy as following:“improved”11/23,“no change”8/23,“worsen”3/23.One dead of tonsillar hernia due to CSFleakage.No other operative complications.